Diabetes Complications: The Long-Term Picture

Diabetes is linked to the development of a number of serious complications. The risk of developing complications exists whether you have type 1 or type 2 diabetes. Heart disease, for example, strikes many people with diabetes – particularly when they do not manage their diabetes well. Fortunately, by managing your diabetes, you can lessen your risk of heart disease and all the other complications.

Achieving good blood sugar levels play a large part in preventing complications, but it’s suspected that genetics may also have a say. However, good control will reduce your chances of developing complications – and this means that, to a large extent, you are in control of your future.

If you already have developed a diabetes-related complication, rest assured that, particularly with early diagnosis, treatment can be very effective.

Your Arteries

Diabetes can cause blood vessel problems such as atherosclerosis (the build-up of plaque deposits in the blood vessels). This build-up can be particularly serious when it affects the coronary arteries, which apply your heart with blood. Also known as macrovascular disease or large blood vessel disease, partial or total blockage of the coronary arteries can lead to a number of very serious complications like angina (chest pains) and heart attack. We don’t know yet why people with diabetes are more likely to develop cardiovascular disease. But, research has found that high blood sugar levels do cause damage to the arteries.

Taking Care of Your Arteries

• Maintain good blood sugar levels.
• Don’t smoke.
• Eat a well-balanced, low-fat diet. Consult a dietician.
• Keep a healthy weight.
• Exercise regularly.
• Check your blood pressure regularly.
• Also, have your doctor regularly check your cholesterol and blood fat (triglyceride) levels.

Your Eyes…

Did you know that diabetes is the most common cause of adult blindness in the western world? Microvascular disease, or small blood vessel disease, begins the process that can lead to partial and – if left untreated – total loss of vision. Retinopathy occurs when the small blood vessels in your retina, the light-sensitive inner lining in the back of your eye, become damaged as a result of high blood sugar levels. Because symptoms don’t arise until the advanced stages of the disease, only regular eye examinations, performed by an experienced eye specialist, will detect the early stages of the disease. Fortunately, with early detection, laser treatment may prevent further damage. Damage to the eye may include haemorrhaging in your eye, the development of scar tissue and retina detachment.

Taking Care of Your Eyes

• Maintain good blood sugar levels.
• Have your eyes examined by an eye specialist at diagnosis and then at least once a year after the age of 15 if you have type 1 diabetes. If you have type 2 diabetes, your
• eyes should be checked at diagnosis, then every two to four years.
• Have your blood pressure checked frequently – high blood pressure increases the risk of retinopathy.
• Notify your doctor of any changes in your vision immediately.

Your Nerves…

Your nerves are covered by cells that are particularly vulnerable to the sugar in your blood. When you have chronic high blood sugar, damage to your nerves – called neuropathy – may occur. Neuropathy can be sensory – nerve damage that can affect your legs, arms, hands, chest or abdomen, resulting in a loss of sensation, pins-and-needles, tingling or pain (and in some cases, limb amputation). It can also be “autonomic”. This means damage to the nerves in your body that control the actions of a number of organs, including the bladder, stomach, intestine and penis (for example, nerve damage can cause impotence).

Taking Care of Your Nerves

• Keep your blood sugar within normal or near-normal levels.
• Inform your doctor about any tingling, pain or numbness in your limbs, chest or abdomen.
• Practice good foot care.

Your Kidneys…

Your kidneys filter out waste products from your blood into your urine. Chronic high blood sugar levels, over time, damage the filtering units in your kidneys. The problem is that once your kidneys are damaged in this way, they cannot be repaired. Once damaged, your kidneys’ condition generally tends to get worse over time. Early detection and treatment are the keys. Early treatment can slow the progress of kidney, or renal disease, and slow the onset of end-stage renal disease. End-stage renal disease occurs when your kidneys function at only 10 percent or less capacity, and requires treatment with either a kidney transplant or dialysis treatment.

Taking Care of Your Kidneys

• Maintain good blood sugar levels.
• Have your blood pressure checked frequently, and treat high blood pressure promptly.
• Know the signs of urinary tract infections – cloudy or bloody urine, a burning sensation, frequent urination, feeling the need for constant urination – and get treatment immediately.
• Have your urine tested for protein at least once a year, including tests for microalbuminuria (small amounts of protein), one of the earliest signs of kidney damage. This may involve collecting your urine for 24 hours.
• Have your blood tested for creatinine. This is a waste product which normal, undamaged kidneys will remove from the blood.
• Eat a well-balanced diet.

Ensuring Good Blood Sugar Control

When you test your blood sugars at home, the meter tells you the level of sugar in your blood that exact moment. Your glycosylated haemoglobin (HbA1c) is a simple blood test done by your doctor. It measures your average blood sugar level over the past three months. It is a good indicator of your overall diabetes control, and a predictor of long-term complications. Have your doctor test your HbA1c every three to six months.

Two Key Words: Control & Prevention

You can greatly reduce your risk of developing the complications associated with diabetes. How? Simply put, what you do today has a good chance of helping you in the future. So, keep your blood sugars as close to normal as possible, maintain your weight at an acceptable level, and live a healthy lifestyle. Read on for practical tips on how to achieve all these.